Objective: To investigate the feasibility and efficacy of single-port laparoscopic high hernia sac ligation with assistance of a self-made thread- attached puncturing needle in treatment of inguinal hernia in children. Methods: The clinical data of 47 pediatric patients with inguinal hernia treated during January 2012 to November 2014 were retrospectively analyzed. Of the patients, 23 cases underwent single-port laparoscopic high hernia sac ligation assisted by self-made thread- attached puncturing needle (laparoscopic group), with general anesthesia; 24 cases were subjected to conventional open hernia sac ligation (open surgery group), with continuous epidural anesthesia. The main clinical variables between the two groups of patients were compared. Results: All laparoscopic procedures were successfully performed, without any conversion to open surgery. In laparoscopic group compared with open surgery group, the operative time was shortened (8.26 min vs. 36.54 min), intraoperative blood loss was decreased (0.63 mL vs. 4.15 mL), length of postoperative hospital stay was reduced (1.39 d vs. 3.75 d), while the hospitalization cost was increased (6 682.18 yuan vs. 4 385.93 yuan), and all the difference had a statistical significance (all P<0.05). Postoperative complications occurred in none of the cases in laparoscopic group, but in 5 cases in open surgery group, which included scrotal hematoma in 3 cases and subcutaneous hematoma in 2 cases, and the overall incidence of postoperative complications had a statistical difference between the two groups (0 vs. 20.8%, P<0.05). No recurrence was found in either of the groups during follow-up period. Conclusion: Single-port laparoscopic high hernia sac ligation assisted by self-made thread- attached puncturing needle in treatment of pediatric inguinal hernia is safe and effective, with the advantages of minimal invasion, no visible scar and less complications.